Claims Processing Specialist - Tarentum, PA

Blackburn'S Physicians Pharmacy; Tarentum (Allegheny County); On-site; USD 40,000 - 65,000; Full time

Benefits offered by this job

Competitive pay and comprehensive bene

Paid time off and holidays

401(k) with profit sharing

Hands-on training and professional dev

Job summary

Blackburn's Physicians Pharmacy, Inc. in Tarentum, PA is seeking a detail-oriented Claims Processing Specialist to join our growing Claims Department. This full-time role offers a daylight schedule and the opportunity to support uninterrupted patient care by handling insurance claims and authorizations.

You will review, process, verify benefits, manage authorizations, monitor denials, and collaborate with billing and clinical teams to ensure timely reimbursements and accurate records.

Qualifications

• Previous experience in healthcare billing, claims processing, DME/HME, or insurance coordination preferred.
• Understanding of Medicare, Medicaid, and commercial insurance processes is a must.
• Strong attention to detail and problem-solving skills.
• Excellent communication and organizational abilities.
• Ability to work independently and as part of a team.
• Comfortable working in a high-volume, deadline-driven environment.
• Basic proficiency with Microsoft Office and computer-based systems.

Responsibilities

• Review, process, and monitor medical insurance claims for accuracy and compliance.
• Verify insurance benefits, authorizations, and documentation needed for submissions.
• Manage authorizations, reauthorizations, and prescription renewals.
• Monitor outstanding claims and follow up with carriers and providers.
• Communicate with insurance representatives to resolve issues and questions.
• Maintain audit-ready records and case notes in company systems.
• Use work queues and reports to prioritize workloads and meet deadlines.
• Collaborate with billing, customer service, and clinical teams to resolve claims efficiently.
• Identify recurring issues and recommend process improvements.

Skills

Attention to detail

Time management

Analytical thinking

Communication skills

Multitasking

Team collaboration

Healthcare claims knowledge

Tools

Microsoft Office

Claims processing systems

Job description

Job Location: Blackburn's Corporate - Tarentum, PA 15084

Job Category: InsuranceBlackburn's Physicians Pharmacy, Inc. | Tarentum, PA

Full-Time | Monday-Friday | Daylight Schedule

Help Patients Access the Care They Need

At Blackburn's Physicians Pharmacy, Inc., we believe access to healthcare starts long before a patient receives their equipment. Every authorization secured, every claim processed, and every reimbursement resolved helps ensure patients receive the medical equipment and services they depend on.

We're looking for a detail-oriented, organized, and motivated Claims Processing Specialist to join our growing Claims Department in Tarentum. If you thrive in a fast-paced healthcare environment, enjoy problem-solving, and take pride in accuracy, this is an opportunity to build a rewarding career while making a meaningful impact on patient care.

What You'll Do

• Review, process, and monitor medical insurance claims for accuracy, completeness, and compliance with payer guidelines.
• Verify insurance benefits, authorization requirements, and documentation needed for claim submission.
• Manage authorizations, reauthorizations, and prescription renewals to support uninterrupted patient care.
• Monitor outstanding claims, investigate denials, and perform timely follow-up with insurance carriers and providers.
• Communicate with insurance representatives to resolve claim issues, missing documentation, and reimbursement questions.
• Maintain accurate account notes, claim documentation, and audit-ready records within company systems.
• Utilize work queues and reporting tools to prioritize workloads and meet filing deadlines.
• Collaborate with billing, customer service, clinical teams, and referral sources to resolve claims efficiently.
• Identify recurring reimbursement issues and recommend process improvements to reduce denials and improve operational efficiency.

What We're Looking For

• Strong attention to detail with exceptional organizational and time management skills.
• Excellent analytical, problem-solving, and critical-thinking abilities.
• Strong verbal and written communication skills.
• Ability to manage multiple priorities while meeting deadlines in a fast-paced environment.
• Proficiency with computers, data entry, and Microsoft Office applications.
• Collaborative mindset with the ability to work independently and across multiple departments.
• Previous experience in healthcare claims processing, medical billing, insurance verification, or prior authorizations preferred.
• Knowledge of Medicare, Medicaid, commercial insurance, or the DME/HME industry is highly preferred.

Why Join Blackburn's?

• Monday-Friday daytime schedule with evenings and weekends off.
• Competitive pay and comprehensive benefits package.
• P aid time off and paid holidays.
• 401(k) with profit sharing.
• Hands-on training and ongoing professional development opportunities.
• Supportive leadership and a collaborative team environment.
• Career growth opportunities within a growing healthcare organization.
• Join a respected, family-owned healthcare company serving our communities for nearly 90 years.

Make an Impact Every Day

Behind every successfully processed claim is a patient receiving the care and equipment they need. As a Claims Processing Specialist, your work helps remove barriers to care, supports timely reimbursement, and ensures patients receive the essential medical equipment that improves their quality of life.

Qualifications

• Previous experience in healthcare billing, claims processing, DME/HME, or insurance coordination preferred
• Understanding of Medicare, Medicaid, and commercial insurance processes is a must
• Strong attention to detail and problem-solving skills
• Excellent communication and organizational abilities
• Ability to work independently and as part of a team
• Comfortable working in a high-volume, deadline-driven environment
• Basic proficiency with Microsoft Office and computer-based systems